Surgical-orthodontic treatment of a patient with temporomandibular disorder stabilized with a gnathologic splint

The condylar position was stabilized with a gnathologic splint designed to achieve a mutually protected occlusion in a patient with internally deranged joints whose symptoms had not been resolved with an anterior repositioning splint. A diagnosis was made in the stable condylar position from which hinge axis movement of the mandible could be performed. After preoperative orthodontic treatment, the mandibular position was restabilized with splint therapy; then, a sagittal split ramus osteotomy was performed, by using an overcorrection splint. As a result, the stable position of the condyles was in line with the centric occlusion of the teeth. Changes in the joint status are illustrated with magnetic resonance images. The occlusion was stable 2 years after active treatment without recurrence of joint symptoms.